Mini-invasive high-tie by clip apposition versus crossectomy by ligature: Long-term outcomes and review of the available therapeutic options

2016 ◽  
Vol 32 (4) ◽  
pp. 249-255 ◽  
Author(s):  
Sergio Gianesini ◽  
Erica Menegatti ◽  
Anna Maria Malagoni ◽  
Savino Occhionorelli ◽  
Paolo Zamboni
Keyword(s):  
Great Saphenous Vein ◽  
Chronic Venous Disease ◽  
High Ligation ◽  
Venous Disease ◽  
Long Term Outcomes ◽  
High Tie ◽  
Very High

Objective The aim of the present study is to compare a mini-invasive (smaller than 2-cm incision) sapheno-femoral high-tie by clip apposition (HT group) with a traditional high-ligation by ligature (HL group). Methods One hundred fifty chronic venous disease patients were included in group HT and compared with 150 cases constituting the group HL. The main outcome was the sonographic detection of saphenous trunk recurrences. Procedural pain, esthetic satisfaction, and disease specific quality of life were assessed. Results At 4.5 ± 2.4 years follow-up, 8 cases (5.3%) of Great Saphenous Vein reflux reappearance were reported in group HT vs. 19 cases (12.6%) (odds ratio: 2.6; 95% confidence interval: 1.1–6.1; P = 0.04) of group HL. Esthetic satisfaction was scored as high and very high in group HT and HL, respectively (P < .0001). Conclusions Proper high-ligation technique provides satisfying outcomes both in terms of recurrence rate and patient esthetic satisfaction. The different outcomes obtained by the two groups encourage further investigations regarding recurrence pathogenesis.

Outcomes of the Modified Endoscopic Lothrop Procedure

2002 ◽  
Vol 16 (5) ◽  
pp. 269-273 ◽  
Author(s):  
Stacey L. Schulze ◽  
Todd A. Loehrl ◽  
Timothy L. Smith
Keyword(s):  
Case Series ◽  
Good Alternative ◽  
Frontal Sinusitis ◽  
Long Term Outcomes ◽  
Postoperative Patient ◽  
Perceived Quality Of Life ◽  
Telephone Questionnaire

Background The aim of this study was to examine the long-term outcomes of the modified endoscopic Lothrop procedure for the management of the most severe forms of recalcitrant chronic frontal sinusitis. Methods This case series evaluated 13 consecutive cases of the modified endoscopic Lothrop procedure for chronic frontal sinusitis from April 1996 to December 1999. Patent communication to the frontal sinus was evaluated by postoperative endoscopic exam. Postoperative patient symptomatology and medication requirements were assessed during clinic evaluation and by standardized telephone questionnaire. Results At a mean follow-up period of 34.5 months, a 77% patency rate was obtained, with 2 of the 13 patients requiring an osteoplastic flap with obliteration. Telephone questionnaire results indicate improved symptoms and decreased medication requirements in the majority of patients who maintained patency. Conclusions These results show that the modified endoscopic Lothrop procedure provides a good alternative to the osteoplastic flap with obliteration for patients with the most severe forms of chronic frontal sinusitis. Initially, high patency rates decline with longer-term follow-up, and severe forms of chronic rhinosinusitis continue to significantly impact patient-perceived quality of life in some patients. The modified endoscopic Lothrop procedure should be reserved for patients who have failed more conservative endoscopic approaches to the frontal recess.

Identifying Effectors of Outcomes in Patients with Large Umbilical Hernias

2016 ◽  
Vol 82 (7) ◽  
pp. 613-621 ◽  
Author(s):  
Steven A. Groene ◽  
Davis W. Heniford ◽  
Tanushree Prasad ◽  
Amy E. Lincourt ◽  
Vedra A. Augenstein
Keyword(s):  
Umbilical Hernia ◽  
Defect Size ◽  
Long Term Outcomes ◽  
Preoperative Pain ◽  
The Mean ◽  
The Difference ◽  
One Year

Quality of life (QOL) has become an important focus of hernia repair outcomes. This study aims to identify factors which lead to ideal outcomes (asymptomatic and without recurrence) in large umbilical hernias (defect size ≥9 cm2). Review of the prospective International Hernia Mesh Registry was performed. The Carolinas Comfort Scale was used to measure QOL at 1-, 6-, and 12-month follow-up. Demographics, operative details, complications, and QOL data were evaluated using standard statistical methods. Forty-four large umbilical hernia repairs were analyzed. Demographics included: average age 53.6 ± 12.0 and body mass index 34.9 ± 7.2 kg/m2. The mean defect size was 21.7 ± 16.9 cm2, and 72.7 per cent were performed laparoscopically. Complications included hematoma (2.3%), seroma (12.6%), and recurrence (9.1%). Follow-up and ideal outcomes were one month = 28.2 per cent, six months = 42.9 per cent, one year = 55.6 per cent. All patients who remained symptomatic at one and two years were significantly symptomatic before surgery. Symptomatic preoperative activity limitation was a significant predictor of nonideal outcomes at one year ( P = 0.02). Symptomatic preoperative pain was associated with nonideal outcomes at one year, though the difference was not statistically significant ( P = 0.06). Operative technique, mesh choice, and fixation technique did not impact recurrence or QOL. Repair of umbilical hernia with defects ≥9 cm2 had a surprising low rate of ideal outcomes (asymptomatic and no recurrence). All patients with nonideal long-term outcomes had preoperative pain and activity limitations. These data may suggest that umbilical hernia should be repaired when they are small and asymptomatic.

scholarly journals Diffusion imaging of cerebral diaschisis in neonatal arterial ischemic stroke

2015 ◽  
Vol 42 (S1) ◽  
pp. S15-S15
Author(s):  
R Srivastava ◽  
T Rajapakse ◽  
J Roe ◽  
X Wei ◽  
A Kirton
Keyword(s):  
Ischemic Stroke ◽  
Diffusion Imaging ◽  
Population Based ◽  
Pediatric Stroke ◽  
Arterial Ischemic Stroke ◽  
Long Term Outcomes ◽  
Primary Injury

Background: Neonatal arterial ischemic stroke (NAIS) is a leading cause of brain injury and cerebral palsy. Diffusion-weighted imaging (DWI) has revolutionized NAIS diagnosis and outcome prognostication. Diaschisis refers to changes in brain areas functionally connected but structurally remote from primary injury. We hypothesized that acute DWI can demonstrate cerebral diaschisis and evaluated associations with outcome. Methods: Subjects were identified from a prospective, population-based research cohort (Calgary Pediatric Stroke Program). Inclusion criteria were unilateral middle cerebral artery NAIS, DWI MRI within 10 days of birth, and >12-month follow-up (Pediatric Stroke Outcome Measure, PSOM). Diaschisis was quantified using a validated software method. Diaschisis-scores were corrected for infarct size and compared to outcomes (Mann-Whitney). Results: From 20 eligible NAIS, 2 were excluded for image quality. Of 18 remaining, 16 (89%) demonstrated diaschisis. Thalamus (88%) was most often involved. Age at imaging was not associated with diaschisis. Long-term outcomes available on 13 (81%) demonstrated no association between diaschisis score and PSOM categories. Conclusion: Cerebral diaschisis occurs in NAIS and can be quantified with DWI. Occurrence is common and should not be mistaken for additional infarction. Determining additional clinical significance will depend on larger samples with long-term outcomes.

Long-term outcomes of an integrative rehabilitation program on quality of life: A follow-up study

2006 ◽  
Vol 61 (6) ◽  
pp. 835-839 ◽  
Author(s):  
Renee R. Taylor ◽  
Sachi G. Thanawala ◽  
Yukiko Shiraishi ◽  
Michael E. Schoeny
Keyword(s):  
Quality Of Life ◽  
Rehabilitation Program ◽  
Long Term Outcomes ◽  
Follow Up Study

The Course of Intellectual Development in Preterm and Fullterm Children: An 8-year Longitudinal Study

1996 ◽  
Vol 19 (3) ◽  
pp. 491-516 ◽  
Author(s):  
Magda Kalmár
Keyword(s):  
Intellectual Development ◽  
Environmental Data ◽  
Biomedical Data ◽  
Contributing Factors ◽  
Long Term Outcomes ◽  
Long Term Follow Up ◽  
Preterm Group

A total of 55 preterm children born at low to moderate risk and a comparison group of 100 healthy fullterm children were studied until they reached 8 years of age. Perinatal biomedical data and environmental data were considered as potential contributors to developmental outcome. The Budapest Binet intelligence quotients (IQs) were used as outcome measures. The mean IQs for both groups fell within the normal range at each measurement point. However, the differential patterns of IQ development in the preterm and term group underscore the significance of the age variable. Instead of a gradually declining impact of prematurity, the age effect resulted in a complex pattern. The considerable intra-group variability within the preterm group and the correlates of outcome suggest that biological hazards related to birth may have subtle long-term influences. Variables tapping the quality of home environment, however, clearly outweighed the perinatal risk factors in their ability to predict long-term outcomes. The results suggest a transaction between the two spheres of contributing factors. Long-term follow-up studies with multiple measurement points are essential if we are to understand the developmental implications of premature birth.

Long-Term Outcomes of Nasoseptal Perforation Repair Using Anterior Maxillary Sinus Wall as an Interpositional Graft

2021 ◽  
pp. 194589242110496
Author(s):  
Jae Woong Hwang ◽  
Mun Soo Han ◽  
Sung Hoon Kang ◽  
Ji Won Kwak ◽  
Hyun Keun Kim ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Surgical Repair ◽  
Treatment Method ◽  
Septal Perforation ◽  
Long Term Outcomes ◽  
Sinus Wall ◽  
Standardized Treatment

Background Various graft materials have been used to repair nasoseptal perforation, but there is no standardized treatment method. The anterior maxillary sinus wall is flattened in appearance and can be easily obtained in a sufficient amount for a large-sized nasoseptal perforation. Objectives The aim of this study is to determine whether the anterior maxillary sinus wall is suitable as an interpositional graft in the surgical repair of septal or nasoseptal perforation. Methods This is a retrospective review of 21 patients who underwent repair of nasoseptal perforation using anterior maxillary sinus wall as an interpositional graft. The etiology, pre- and post-operative NOSE and GBI score, and perforation size were reviewed. The surgical outcome was considered successful if total closure was achieved after postoperative follow-up. Results 19 of the 21 perforations were successfully repaired with anterior maxillary sinus wall. Failure of the repair was found in 2 patients. Causal etiology of perforation was previous septoplasty in 10 patients, and electrocautery in 1 case, but not identified in 10 cases. The largest size was 2.7 × 2.2 cm. The most common symptoms were epistaxis, crusting, and nasal obstruction. Closure of septal perforation resulted in improved subjective symptoms and quality of life which were evaluated with NOSE and GBI score. Conclusion Anterior maxillary sinus wall as interpositional graft between mucoperichondrial flaps can be used to reliably repair nasoseptal perforations.

Quality of life in patients with chronic venous disease in Turkey: influence of different treatment modalities at 6-month follow-up

2015 ◽  
Vol 25 (6) ◽  
pp. 1527-1536 ◽  
Author(s):  
Kadir Çeviker ◽  
Şahin Şahinalp ◽  
Erdinç Çiçek ◽  
Deniz Demir ◽  
Dinçer Uysal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Venous Disease ◽  
Treatment Modalities ◽  
Venous Disease

scholarly journals Outcomes following lymphaticovenous anastomosis (LVA) for 100 cases of lymphedema: results over 24-months follow-up

2020 ◽  
Vol 184 (1) ◽  
pp. 173-183
Author(s):  
Shan S. Qiu ◽  
Tim Pruimboom ◽  
Anouk J. M. Cornelissen ◽  
Rutger M. Schols ◽  
Sander M. J. van Kuijk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Primary Outcome ◽  
Lymphatic Drainage ◽  
Long Term Outcomes ◽  
Compression Garments

Abstract Purpose Lymphedema is a debilitating condition that significantly affects patient’s quality of life (QoL). The aim of this study was to assess the long-term outcomes after lymphaticovenous anastomosis (LVA) for extremity lymphedema. Methods A single-center prospective study on upper and lower extremity lymphedema patients was performed. All LVA procedures were preceded by outpatient Indocyanine Green (ICG) lymphography. Quality of life measured by the Lymph-ICF was the primary outcome. Limb circumference, use of compression garments, and frequency of cellulitis episodes and manual lymphatic drainage (MLD) sessions were secondary outcomes. Results One hundred consecutive patients, predominantly experiencing upper extremity lymphedema following breast cancer (n = 85), underwent a total of 132 LVAs. During a mean follow-up of 25 months, mean Lymph-ICF score significantly decreased from 43.9 preoperative to 30.6 postoperative, representing significant QoL improvement. Decrease in upper and lower limb circumference was observed in 52% of patients with a mean decrease of 6%. Overall mean circumference was not significantly different. Percentage of patients that could reduce compression garments in the upper and lower extremity group was 65% and 40%, respectively. Number of cellulitis episodes per year and MLD sessions per week showed a mean decrease of respectively 0.6 and 0.8 in the upper extremity and 0.4 and 1.0 in the lower extremity group. Conclusions LVA resulted in significant QoL improvement in upper and lower extremity lymphedema patients. Limb circumference did not significantly improve but good results concerning compression garments, cellulitis episodes, and MLD sessions were obtained. Additionally, a simple and patient-friendly method for outpatient ICG lymphography is presented.

scholarly journals VenaSeal for vertical veno-venous reflux elimination in patients with chronic venous disease

2021 ◽  
Vol 18 (1) ◽  
pp. 48-54
Author(s):  
S. M. Belentsov
Keyword(s):  
Quality Of Life ◽  
Varicose Veins ◽  
Pain Syndrome ◽  
Chronic Venous Disease ◽  
Long Term Results ◽  
Venous Disease ◽  
Open Label ◽  
Saphenous Veins

Introduction. Chronic venous disease significantly reduces quality of life and often leads to complications. The only way to eliminate hemodynamically significant blood flow disorders is the surgical method, incl. its latest modification is the VenaSeal.Objective of the study. To study the immediate and long-term results of the use of VenaSeal adhesive technology to obliterate the incompetent major saphenous veins, as well as the potential benefits in special groups of patients based on three-year experience in using VenaSeal Glue Procedure.Materials and methods. Over a 3-year period, we have treated 104 patients with VenaSeal. The average age was 59.6 ± 14.97 years, the CEAP class was 3.2 ± 1.09. 101 patients had varicose veins, in three cases - post-thrombotic. The intervention was performed on 117 incompetent main veins: GSV – 107, SSV – 10.Results and discussion. Clinical evaluation and ultrasound imaging of veins immediately after the intervention of vein occlusion throughout the intervention. There was no pronounced pain syndrome after surgery. Complications occurred in 3 patients in the form of chemical phlebitis. Long-term results up to 3 years were studied clinically and using ultrasound in 72 patients (76 veins): recanalization was noted in 2 GSV (2.6%), which in one case was accompanied by the formation of a recurrent varicose veins. To study the effect of VenaSeal on the quality of life in a comparative aspect, a non-randomized, single-center, open-label study was carried out; it included patients, incl. with GSV occlusion using RFA and EVLT. In the group of patients after VenaSeal, the quality of life indicators were better values. In addition, the absence of the need for elastic compression made the surgical treatment of patients with chronic venous disease and concomitant lesions of the peripheral arterial bed. In groups of elderly and senile patients, patients with weeping eczema, with obesity, additional advantages were found in the form of a decrease in the invasiveness of the intervention and the possibility of correcting reflux as a hemodynamic basis for the development of trophic disorders with the aim of their faster and more effective relief.Conclusions. Non-thermal obliteration of incompetent major saphenous veins using VenaSeal in varicose veins and post-thrombotic disease is highly effective: the immediate results assessed with clinical methods and using ultrasound duplex scanning confirmed the occlusion of the target vein in all cases. The study of long-term results revealed recanalization of two veins out of 76, which accounted for 2.6%.

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